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AN INTEGRATED PERSPECTIVE ON THE ASSESSMENT OF TECHNOLOGIES: INTEGRATE-HTA

Published online by Cambridge University Press:  31 July 2017

Philip Wahlster ,
Louise Brereton ,
Jacob Burns ,
Björn Hofmann ,
Kati Mozygemba ,
Wija Oortwijn ,
Lisa Pfadenhauer ,
Stephanie Polus ,
Eva Rehfuess  and
Imke Schilling
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Philip Wahlster
Affiliation:
Department of Health Services Research, University of Bremen Center for General Practice, Medical Faculty, Saarland Universityphilip.wahlster@uni-saarland.de
Louise Brereton
Affiliation:
ScHARR, University of Sheffield College of Health Sciences, University of Lincoln
Jacob Burns
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Björn Hofmann
Affiliation:
Centre for Medical Ethics, University of Oslo Institute for the Health Services, Norwegian University for Science and Technology (NTNU)
Kati Mozygemba
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen
Wija Oortwijn
Affiliation:
ECORYS Netherlands BV, Rotterdam
Lisa Pfadenhauer
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Stephanie Polus
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Eva Rehfuess
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Imke Schilling
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen
Gert Jan van der Wilt
Affiliation:
Radboud University Medical Center, Nijmegen
Ansgar Gerhardus
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen
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Abstract

Objectives: Current health technology assessment (HTA) is not well equipped to assess complex technologies as insufficient attention is being paid to the diversity in patient characteristics and preferences, context, and implementation. Strategies to integrate these and several other aspects, such as ethical considerations, in a comprehensive assessment are missing. The aim of the European research project INTEGRATE-HTA was to develop a model for an integrated HTA of complex technologies.

Methods: A multi-method, four-stage approach guided the development of the INTEGRATE-HTA Model: (i) definition of the different dimensions of information to be integrated, (ii) literature review of existing methods for integration, (iii) adjustment of concepts and methods for assessing distinct aspects of complex technologies in the frame of an integrated process, and (iv) application of the model in a case study and subsequent revisions.

Results: The INTEGRATE-HTA Model consists of five steps, each involving stakeholders: (i) definition of the technology and the objective of the HTA; (ii) development of a logic model to provide a structured overview of the technology and the system in which it is embedded; (iii) evidence assessment on effectiveness, economic, ethical, legal, and socio-cultural aspects, taking variability of participants, context, implementation issues, and their interactions into account; (iv) populating the logic model with the data generated in step 3; (v) structured process of decision-making.

Conclusions: The INTEGRATE-HTA Model provides a structured process for integrated HTAs of complex technologies. Stakeholder involvement in all steps is essential as a means of ensuring relevance and meaningful interpretation of the evidence.

Keywords

Health technology assessmentStakeholder involvementDecision makingComplex interventionsLogic model
Type
Theme Submissions
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 5: Assessing Health Technologies in an Integrated Way-Results of the INTEGRATE-HTA Project , 2017 , pp. 544 - 551
Copyright
Copyright © Cambridge University Press 2017 

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References

REFERENCES

1. European Network for Health Technology Assessment (EUnetHTA). HTA definition. 2016. http://www.eunethta.eu/about-us/faq#t287n73 (accessed December 5, 2016).Google Scholar
2. Medical Research Council. Developing and evaluating complex interventions: New guidance. United Kingdom: MRC; 2008.Google Scholar
3. Horton, R. Offline: The error of our health technology assessment ways. Lancet. 2013;382:1318.CrossRefGoogle Scholar
4. Benton, V, Stewart, T. Multiple criteria decision analysis - An integrated approach. New York: Springer US; 2002.Google Scholar
5. Wahlster, P, Goetghebeur, M, Kriza, C, et al. Balancing costs and benefits at different stages of medical innovation: A systematic review of Multi-criteria decision analysis (MCDA). BMC Health Serv Res. 2015; 15: 262.CrossRefGoogle ScholarPubMed
6. Wahlster, P, Goetghebeur, M, Schaller, S, Kriza, C, Kolominsky-Rabas, P, EMN’, National Leading-Edge Cluster Medical Technologies ‘Medical Valley. Exploring the perspectives and preferences for HTA across German healthcare stakeholders using a multi-criteria assessment of a pulmonary heart sensor as a case study. Health Res Policy Syst. 2015;13:24.CrossRefGoogle ScholarPubMed
7. Brereton, L, Wahlster, P, Lysdahl, KB, et al. Integrated assessment of home based palliative care with and without reinforced caregiver support: A demonstration of INTEGRATE-HTA methodological guidances. 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
8. Lysdahl, KB, Mozygemba, K, Burns, J, et al. Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
9. Pfadenhauer, L, Rohwer, A, Burns, J, et al. Guidance for the assessment of context and implementation in health technology assessments (HTA) and systematic reviews of complex interventions: The context and implementation of complex interventions (CICI) framework. 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
10. Booth, A, Noyes, J, Flemming, K, et al. Guidance on choosing qualitative evidence synthesis methods for use in health technology assessments of complex interventions 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
11. Rohwer, A, Booth, A, Pfadenhauer, L, et al. Guidance on the use of logic models in health technology assessments of complex interventions. 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
12. Van Hoorn, R, Tummers, M, Kievit, W, Van der Wilt, GJ. Guidance for the assessment of treatment moderation and patients' preferences. 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
13. Wahlster, P, Brereton, L, Burns, J, et al. Integrated assessment of complex health technologies - The INTEGRATE-HTA Model. 2016. http://www.integrate-hta.eu/downloads/ (accessed December 5, 2016).Google Scholar
14. Brereton, L, Ingleton, C, Gardiner, C, et al. Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries. Palliat Med. 2017;31:181192.CrossRefGoogle ScholarPubMed
15. Squires, JE, Valentine, JC, Grimshaw, JM. Systematic reviews of complex interventions: Framing the review question. J Clin Epidemiol. 2013;66:1215–1222.CrossRefGoogle ScholarPubMed
16. Goetghebeur, MM, Wagner, M, Khoury, H, et al. Evidence and value: Impact on DEcisionMaking–the EVIDEM framework and potential applications. BMC Health Serv Res. 2008;8:270.CrossRefGoogle ScholarPubMed
17. Lampe, K, Makela, M, Garrido, MV, et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. Int J Technol Assess Health Care. 2009;25 (Suppl 2):9–20.CrossRefGoogle Scholar
18. International Network of Agencies for Health Technology Assessment (IANHTA). Glossary. 2015. http://www.inahta.org/Glossary (accessed December 5, 2016).Google Scholar
19. The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual 2014 Edition. Australia: Joanna Briggs Institute, 2014.Google Scholar
20. Rohwer, A, Pfadenhauer, L, Burns, J, et al. Logic models help make sense of complexity in systematic reviews and health technology assessments. J Clin Epidemiol. 2017;83:37–47.CrossRefGoogle ScholarPubMed
21. Polus, S, Pfadenhauer, L, Brereton, L, et al. A consultation guide for assessing the applicability of health technologies - a case study. Int J Technol Assess Health Care. 2017 [This issue.]CrossRefGoogle Scholar
22. DeGroot, MH. Reaching a consensus. J Am Stat Assoc. 1974;69:118–121.CrossRefGoogle Scholar
23. Lysdahl, KB, Hofmann, B. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment. GMS Health Technol Assess. 2016;12:Doc01.Google ScholarPubMed
24. Bond, K, Weeks, L. Using the INTEGRATE-HTA guidance: Experience from CADTH. Int J Technol Assess Health Care. 2017 [This issue.]CrossRefGoogle ScholarPubMed